A woman is to receive amoxicillin-clavulanate 500 mg PO every 8 hours for bronchitis. The nurse retrieves two 250-mg tablets from the medication cart. This is incorrect for which of the following reasons?A. The amount of sulbactam in amoxicillin-clavulanate 250 mg is 62.5 mg per tablet, twice the intended amount. B. This provides twice the intended dose of clavulanate. C. The 250-mg tablets have less absorption than the 500-mg tablets. D. Administration of amoxicillin-clavulanate is only intravenous, so selecting tablets means that the wrong drug is being administered.
B
The incorrect reason for retrieving two 250-mg tablets of amoxicillin-clavulanate for a dose of 500 mg PO every 8 hours for bronchitis is option A – “The amount of sulbactam in amoxicillin-clavulanate 250 mg is 62.5 mg per tablet, twice the intended amount.” This option is incorrect because sulbactam is not present in amoxicillin-clavulanate tablets. Amoxicillin-clavulanate is a combination of two antibiotics – amoxicillin and clavulanic acid. Therefore, option B – “This provides twice the intended dose of clavulanate.” is the correct reason for the retrieval of two 250-mg tablets being incorrect. Retrieval of two 250-mg tablets instead of one 500-mg tablet would result in administering twice the recommended dose of clavulanate. The correct dose of amoxicillin-clavulanate for this patient is one 500-mg tablet every 8 hours. Option C and D are also incorrect because absorption is not a concern between 250-mg and 500-mg tablets of the same medication, and amoxicillin-clavulanate is available in both oral and intravenous forms.
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